Speech therapy and voice restoration after cancer – Macmillan Cancer Support

[Sound of television in background] My name is Kelly Jackson-Waite. I’m a Macmillan speech and language therapist and I work.


[Sound of television in background] My name is Kelly Jackson-Waite. I’m a Macmillan
speech and language therapist and I work for the Northamptonshire Provider
Services. Speech therapy involves working with people
who have difficulties with speech or with swallowing following head and neck
cancer. [New speaker] My name is Mick. You will notice
that I have to keep pressing this object on the front of my neck.
This is the only way that I can speak. It’s called an HME. Which is heat moisture
exchange. An example of head and neck cancer is laryngeal
cancer. Laryngeal cancer is cancer in your larynx
which is a box-like structure which you can feel in your neck.
Your larynx has your vocal cords which, when they move together they vibrate and that’s
how you produce voice. And when they do the surgery they take the
whole larynx out which is at the top of your airway, your trachea,
so they have to divert your trachea so that you breathe through your neck.
They create an opening on your neck so that you breathe through your neck
and they’ve taken your vocal cords out so after surgery we have to find a different
way for you to speak. The voice prosthesis is a silicone device
which sits between the back of the airway and the gullet,
so when the stoma is covered the air is pushed through the valve, which is a one-way valve,
up into the mouth so that voice can be produced by a segment of the pharynx being vibrated
to produce voice. [New speaker] I was told that I would have
to learn to speak again after the operation but ten minutes after I had the valve fitted
I was on the phone speaking to all my family. It was great. My family could not believe
I was on the end of the phone talking to them because they thought
that I may never speak again or it would be a very long time.
This is another option that laryngectomy patients can use.
It’s an artificial larynx and it’s for those patients that are unable
to have a surgical voice restoration the surgery has been quite difficult or complicated
and it works by pressing it onto the side of the neck and when you press
the button it vibrates to give an artificial speech
[Demonstrating the artificial larynx] Hello, how are you?
The impact is huge for those who are faced with having to go through a laryngectomy.
They’ve got to come to terms with the fact that their anatomy is going to change,
they’re going to be breathing differently. They’re going to be learning how to talk in
a different way. The implications on a social level and a psychological
level are very different and it’s going to take
a long time to come to terms with that,
and as a speech therapist we’re available to help them through the whole process
and we can provide them with information preoperatively and also after the operation we can help them
with various aspects of the rehabilitation in terms of helping them
with surgical voice restoration or other modes of communication. Whatever
is appropriate for them. Also with the coming to terms with all the
different changes that have happened and the psychological and emotional support
that goes with that, and that will go on for as long as they need
it. And we see them for a long time because they
come back for support with their stoma and their speaking
valve. We can offer them what they need.
Any time I need a valve changing I just ring them up
and I’m normally in the hospital within one hour.
And I couldn’t ask for anything better than the care that I get from those two ladies.
The most rewarding part of my job is three weeks after having a laryngectomy
is when you can start teaching the patient how to use their valve.
So from not having any speech to suddenly being able to use the speech valve
and develop the speech and being able to communicate again with family and friends
I find that incredibly rewarding. If you have any concerns contact your local
speech therapist or your local specialist nurse in head and
neck cancer or just look on the Macmillan website for
the appropriate person in your local area [Announcer] For information, help, or if you just want to chat call the Macmillan Support Line on 0808 808
00 00 or visit macmillan.org.uk

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